Erschienen in:
28.11.2016 | Pancreatic Tumors
Shape and Enhancement Characteristics of Pancreatic Neuroendocrine Tumor on Preoperative Contrast-enhanced Computed Tomography May be Prognostic Indicators
verfasst von:
Hirohisa Okabe, MD, PhD, Daisuke Hashimoto, MD, PhD, Akira Chikamoto, MD, Morikatsu Yoshida, MD, PhD, Katsunobu Taki, MD, PhD, Kota Arima, MD, Katsunori Imai, MD, PhD, Yoshitaka Tamura, MD, Osamu Ikeda, MD, Takatoshi Ishiko, MD, PhD, FACS, Hideaki Uchiyama, MD, PhD, FACS, Toru Ikegami, MD, PhD, FACS, Norifumi Harimoto, MD, PhD, Shinji Itoh, MD, PhD, Yo-ichi Yamashita, MD, PhD, FACS, Tomoharu Yoshizumi, MD, FACS, Toru Beppu, MD, PhD, FACS, Yasuyuki Yamashita, MD, PhD, Hideo Baba, MD, PhD, FACS, Yoshihiko Maehara, MD, PhD, FACS
Erschienen in:
Annals of Surgical Oncology
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Ausgabe 5/2017
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Abstract
Background
Prognostic indicators of the malignant potential of pancreatic neuroendocrine tumors (PNET) are limited. We assessed tumor shape and enhancement pattern on contrast-enhanced computed tomography as predictors of malignant potential.
Methods
Sixty cases of PNET patients undergoing curative surgery from 2001 to 2014 were enrolled onto our retrospective study. Preoperative enhanced CTs were assessed, and criteria defined for regularly shaped and enhancing tumors (group 1), and irregularly shaped and/or enhancing tumors (group 2). The relation of tumor shape and enhancement pattern to outcome was assessed.
Results
Interobserver agreement was substantial (kappa = 0.74). Group 2 (n = 24) was significantly correlated with synchronous liver metastasis (23 vs. 0 %), lymph node metastasis (36 vs. 3 %), pathologic capsular invasion (68 vs. 8 %), larger tumor size (30 vs. 12 mm), tumor, node, metastasis classification system (TNM) stage III/IV disease (46 vs. 3 %), and histologic grade 2/3 (41 vs. 0 %). Multivariate analysis revealed that tumor grade 2/3 and group 2 criteria correlated with tumor relapse (hazard ratio 6.5 and 13.6, P = 0.0071 and 0.039, respectively), and that only group 2 criteria were independently correlated with poor overall survival (hazard ratio 5.56e + 9, P = 0.0041).
Conclusions
Irregular tumor shape/enhancement on preoperative computed tomography is a negative prognostic factor after curative surgery for PNET.